From:
"RD"
Date: 2011-10-05 06:40:57 UTC
Subject: [ferrethealth] Odie's very low heart rate
To: ferrethealth@yahoogroups.com
Short version:
Patient: 9 year old male MF ferret with IBD, an abdominal mass and liver disease
Meds: prednisolone (0.1 mg bid), lasix (2 mg bid) and lactulose (1.5 g bid)
Hx of current illness: lethargy, lack of energy beginning Fri or Sat; poops with some orange tinge and firm enough for his diet; eating/drinking/pooping/peeing
X-ray: abdominal mass has grown and the liver is enlarged; lungs and heart appear normal
EKG: inconclusive
Heart rate: 80-85 bpm; respirations: normal, but breathing seems labored
Treatment: Because of inconclusive EKG, she did not want to start on any heart meds. She did increase the lasix to 3 mg bid for 3 days. I will also give B12 injections daily.
Differential diagnosis: Is enlarged liver causing decreased heart rate or is this a heart disease complication? Should we attempt a heart med or not?
Thoughts? Suggestions? Advice?
Narrative (more details):
Odie is a 9 year old Marshall Farms male with IBD, abdominal mass and liver disease. He is currently on prednisolone (0.1 mg bid), lasix (2 mg bid) and lactulose (1.5 g bid). I add milk thistle to the gravy, which he gets twice a day and he free feeds on Totally Ferret turkey-venison-lamb. His poops are firm enough for his diet, and appear normal.
Odie became a bit lethargic this weekend, acting like he had no energy and slipping on the hardwood floor. His poop shows a bit more orange in it, but otherwise appears normal. He can walk about 3 feet and then would lie down, exhausted. His heart rate was very slow, but his lungs sounded clear and he did not appear to be in pain, so I waited until Monday morning to take him to the vet, convinced that he had little time left.
My regular vet was not there, so the partner took a ferret view x-ray. A comparison of the last one and this showed that the abdominal mass has grown and the liver is enlarged. In the past, liver values have waxed and waned, not become progressively worse. I left him there and she gave him some injectable lasix, sub-q fluids and a vit. B shot. I took him home Monday night and called the regular vet today.
Early this morning he climbed off the bed and into the next room to eat some kibble. He then collapsed and went to sleep. He seems okay when he rests, but is easily tired out. I tell you all this as an example that he seems to want to maintain his regular activity level, but does not have the energy.
I took him to the vet this afternoon, thinking it might be time to let him go. At the vet, he tried to explore and walked across the room to use the corner. It exhausted him, but he didn't seem ready to check out. The vet listened to his chest and his lungs are clear. His heart rate is so slow that it hides in his breath sounds. I get it at 80 - 85 bpm. So does my vet. We attempted an EKG, but the results were inconclusive. The EKG was done by a tech and there is not a cardiologist here who can get more. Because of this, she did not want to start on any heart meds. She did increase the lasix to 3 mg bid for 3 days.
Thoughts? Suggestions? Advice? I am in Alaska and we have very few advanced options here. However, I do have a ferret vet who is open to input. Since Odie is not hurting, and still has enough drive to get up and look for food and explore, I am not inclined to euthanasia. I prefer that they go out on their own, but do not allow them to suffer.
Thank you!
Renee Downs
Anchorage, AK
[Has your vet considered doing the atropine response test? This was recommended to my vet by a veterinary cardiologist when I had a ferret with extremely low heart rate, i.e., 80bpm. The results, which included an EKG, were posted onto VIN and read by 2 cariologists, who confirmed AV heart block. -Moderator (TD)].
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